An  Evalua)on  of  Smoke  Alarm  Installa)on  and  Community  Risk  Reduc)on  Programs  in  Five  U.S.  Fire  Departments

Shane Diekman, PhD, MPH

Behavioral Scientist, Home and Recreation Team Leader CDC/NCIPC/DUIP

Presentation Outline

•  Formative Research – Global Research – CDC SAIFE Program

•  Demonstration Projects •  Evaluation Objectives •  Evaluation Findings

FORMATIVE RESEARCH

Select Global Comparisons

Trends in Civilian Fire Death Rates

Trends in Civilian Fire Death Rates

Global Research Conducted by TriData Prior work in 1982-1983 Recent research in 2006-2009

–  2006/7: Europe England, Scotland, Sweden, Norway

–  2007/8: Pacific Rim Australia, New Zealand, Japan

–  2008/9: North America Canada, Mexico, Puerto Rico, Dominican Republic

Global Research Findings Increase emphasis on prevention, especially for residential fire safety Drop mandatory standards of cover Adopt an integrated risk management (community risk reduction) approach

Business and prevention plans made and tracked by fire station Target prevention to high-risk groups

Identified by GIS analysis and socioeconomic data

Visit high risk homes (50%-100%)

–  Use firefighters and community volunteers or staff

–  Visit by appointment or cold calls after local publicity

–  Offer to install free smoke alarms.

–  Educate, test/install alarms, inspect/mitigate hazards

– 

Home Safety Visits: The Best “New Practice”

CDC SAIFE Program

Homes Canvassed 611,047

Homes Enrolled 278,872

Smoke Alarms Installed 553,167

Lives Potentially Saved 3,755

CDC SAIFE Program

As of September 2011

“The future is here. It is just not widely distributed yet.”

William Gibson - Novelist

DEMONSTRATION PROJECTS

Demonstration Projects •  FEMA-funded 2009-2011 •  Administered by Washington State Association of Fire

Marshals •  Evaluated by University of Washington PRC

•  Five implementation sites

–  Dallas –  Portland –  Tucson –  Wilmington –  Vancouver

Approach •  Phase I – Smoke Alarm Installation

–  Targeted approach to high risk neighborhoods –  Installation and Education –  Follow up and Evaluation

•  Phase II – Community Risk Reduction –  Identify and prioritize community risks –  Develop appropriate strategies and tactics –  Prepare and Implement plan –  Monitor and Evaluate program

Community Risk Reduction (CRR) 1. Identify

Risks 2. Prioritize Risks

3. Develop Strategies/Tactics

to Mitigate

4. Prepare CRR Plan

5. Implement CRR Plan

6. Monitor & Evaluate

EVALUATION OBJECTIVES

Evaluation Framework

Process evaluation conducted with each site

Data collected in homes to establish baseline and measure improvement

Fire incidence and census data used to begin tracking impact on reported home fires & deaths

Results intended to demonstrate value of prevention programs

Evaluation Objectives Purpose of evaluation:

Describe the programs (Program Descriptions), their implementation (Process Evaluation), and associated costs (Program Costs)

Describe the short- and long-term outcomes (Impact & Outcome Evaluations)

Summarize the Lessons Learned

Identify the Key Program Components

EVALUATION FINDINGS

Program Descriptions Tucson   Medium-­‐sized,  career  fire  department;  

installa7ons  completed  by  community  partner  (SERI)  

Vancouver   Small-­‐sized,  mixed  fire  department;  union;  experience  with  CRR;  installa7ons  completed  in  pairs  of  volunteer  firefighters  and  community  volunteers  

Dallas   Large-­‐sized,  career  fire  department;  20+  year  history  of  smoke  alarm  installa7on  efforts;  installa7ons  completed  in  pairs  of  firefighters  and  volunteers  

Portland   Medium-­‐sized,  career  fire  department;  installa7ons  completed  by  firefighters  

Wilmington   Small-­‐sized,  career  fire  department;  installa7ons  completed  by  firefighters  

Site Specifics Tucson   (Phase  I)  –  Smoke  Alarm  Installa7on  

(Phase  II)  –  Community  partnership,  CRR  computer  training  for  FD’s  

Vancouver   (Phase  I)  –  Smoke  Alarm  Installa7on  (Phase  II)  –  All  sta7ons  included,  School  based  approach  

Dallas   (Phase  I)  –  Smoke  Alarm  Installa7on  (Phase  II)  -­‐  Sta7on  based  approach,  Produced  educa7onal  DVD’s  

Portland   (Phase  I)  –  Smoke  Alarm  Installa7on  (Phase  II)  –  Crew  based  approach,  Community  radio  campaign  

Wilmington   (Phase  I)  –  Smoke  Alarm  Installa7on  (Phase  II)  –  Community  partnerships,  College  student  PSA’s  

Process Evaluation

No. Fire Departments………………….. 5 Duration of Program…………………… 2 years* # homes visited………………………. 5,249

No Alarm Present………………………. 40% No Functioning Alarm Present………… 55% No Home Escape Plan………………… 74% No Practice of Escape Plan…………… 88% *2 years in the field

Home Visits

Homes With No Functioning Alarm

39%  

20%  

72%  

10%  

27%  

40%  

22%  

25%  

6%  

10%  

17%  

15%  

0%  

10%  

20%  

30%  

40%  

50%  

60%  

70%  

80%  

90%  

Dallas   Portland   Tucson   Vancouver   Wilmington   ALL  

No  Alarm  Present   Alarm  Present  -­‐  but  NOT  Working  

61%  

45%  

78%  

20%  

44%  

55%  

Escape Plan and Practice

13%   13%  

1%  

18%   19%  12%  

19%  

1%  

1%  

22%   23%  

15%  

0%  

5%  

10%  

15%  

20%  

25%  

30%  

35%  

40%  

45%  

Dallas   Portland*   Tucson   Vancouver   Wilmington   ALL  SITES  

Have  &  Prac7ced   Have  -­‐  NOT  Prac7ced  

14%  

40%   42%  

27%  32%  

2%  

Impact Evaluation

-­‐14.1   -­‐15.6  

-­‐59.7  

-­‐29.8  

6.1  18.9  

-­‐21.8  

1.0  

-­‐70.0  

-­‐60.0  

-­‐50.0  

-­‐40.0  

-­‐30.0  

-­‐20.0  

-­‐10.0  

0.0  

10.0  

20.0  

30.0  

PORTLAND   VANCOUVER   WILMINGTON   AVG  ALL  SITES  

Targeted    

Non-­‐Targeted  

•  15,983 smoke alarms installed Home Fires per 100,000: Change between Pre & Post Intervention

Outcome Evaluation

Deaths per 1,000 Home Fires Change between Pre & Post Periods

-­‐9.8  

0.0  

-­‐17.7  -­‐9.1  

-­‐4.0  

21.8  

45.8  

21.2  

-­‐30.0  

-­‐20.0  

-­‐10.0  

0.0  

10.0  

20.0  

30.0  

40.0  

50.0  

Portland   Vancouver   Wilmington   Avg.  All  Sites  

Targeted  

Non-­‐Targeted  

Program Costs

Present  Study   Other  Studies  Avg.  Cost   Range   Range  

Per  Installed  Alarm:   $34   $20-­‐$78   $53-­‐126  

Per  Home  Visit:   $107   $85-­‐$269   $135-­‐$242  

•  Phase I – Smoke Alarm Installation –  Emphasize need and department’s commitment –  Develop accountability systems for alarms & forms –  Plan in advance for follow-up w. residents not home –  Choose times when people are likely home & receptive –  Not all volunteer groups are equal –  Address common firefighter concerns

•  Phase II – Community Risk Reduction –  Involve entire station(s) –  Developing community partnerships take time

Lessons Learned

•  Clear Vision •  Reasonable expectations •  Buy-in Senior Management •  Knowledge of FMAs •  Point Person •  Adequate Resources/Tools •  Knowledge of Community Resources •  Training for staff/volunteers

Key Program Components Phase I and Phase II

•  Potential to: –  Increase the presence of working smoke alarms –  Change culture towards prevention –  Substantially reduce fires deaths and injuries

•  Further Research:

–  Implement larger scale programs –  Assess CRR impact on perceptions –  Enhance alarm technology –  Address human behavior

•  Escape planning, alarm maintenance

Conclusions

Thank You

Shane Diekman, PhD, MPH Behavioral Scientist, Home and Recreation

Team Leader CDC/NCIPC/DUIP

scd0@cdc.gov